The Missing Pages: The Origin of Alice Wonderland Syndrome

Author(s): Stefan Bittmann*

Editorial:

The Alice in Wonderland syndrome is a syndrome in which people perceive themselves or their surroundings as changing in a hallucinatory way [1]. The phenomenon is not considered a separate disease, but usually occurs as a symptom accompanying a migraine attack or as a precursor to an epileptic seizure in the form of an aura with pronounced visual perceptual disturbances. An Alice in Wonderland syndrome can also be caused by the Epstein-Barr virus or drugs [2-4]. The term "Alice in Wonderland syndrome" was named after the children's book Alice in Wonderland by Lewis Carroll and coined by John Todd as a possible, but not essential, accompanying symptom of migraine and epilepsy. Carroll himself suffered from migraines, and it is believed that his experiences with the condition served as inspiration for the hallucination-like effects described in his work [5]. In addition, Carroll's story has been discussed as a description of a trip after consuming consciousnessaltering drugs. In one of the most famous sequences of the book, Alice changes her size by taking bites from different sides of a mushroom. The Alice in Wonderland syndrome leads to changes in the perception of one's own environment [6]. These changes include both micropsia and macropsia, as well as altered auditory perception, altered tactile sensations, and altered perception of time [7,8]. There is only speculation about the causes, as the corresponding diaries of Charles Dodgson from that time are missing, and Carroll's letters to Alice were destroyed by her mother. Speculations range from his alleged infatuation with Alice and the desire to marry her to assumptions that a romantic relationship with Alice or Alice eldest sister Ina was developing. The syndrome is particularly common in children. The attacks are often shorter and can also be completely painless, although accompanying symptoms such as nausea, vomiting, light and noise sensitivity are more pronounced. This can lead to neurological deficits, causing the affected child to start hallucinating. They may perceive their body as larger or smaller and/ or start to see "fantastic images." The changes in perception can greatly impair those affected, causing them to lose their orientation and "not be able to find their way." In extreme cases, falls and other accidents can occur. The perceptual disturbances can lead to the Alice in Wonderland syndrome being mistaken for other mental disorders or misinterpreted as "madness".